脑卒中手术患者医院感染危险因素分析
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摘要
目的调查脑卒中手术患者医院感染现况,探讨其发生医院感染的危险因素。方法采用自行编制的《脑卒中手术患者医院感染目标性监测调查表》纳入2016年1月1日-2017年12月31日收治在某三级甲等综合教学医院神经外科所有符合标准的患者。结果共纳入脑卒中手术患者466例,发生医院感染133例、154例次,医院感染率为28. 54%;出血性脑卒中、入院格拉斯哥昏迷评分(GCS)、住院天数、静脉血栓、术后第1日体温和机械通气是脑卒中手术患者医院感染的独立危险因素。结论脑卒中手术患者是医院感染高危人群,应针对危险因素采取有效预防控制措施,以期降低医院感染率。
Objective To investigate the current status of healthcare-associated infection among stroke patients undergoing surgical treatment,and to explore the risk factors of healthcare-associated infection. Methods Eligible patients hospitalized in the neurosurgery department in a tertiary comprehensive teaching hospital from January 1 st,2016 to December31 st,2017 were recruited. Necessary information of patients was collected and filled in the self-designed forms: Target surveillance investigation forms of healthcare-associated infection among stroke patients undergoing surgical treatment. Results Overall,466 eligible patients were enrolled in this study,133 healthcare-associated infection cases( 154 episodes),and the incidence of healthcare-associated infection was 28. 54%. Healthcare-associated infection risk factors for stroke patients undergoing surgical treatment were identified with the hemorrhagic stroke,Glasgow Coma Scale( GCS) at admission,length of stay( LOS),venous thrombosis,postoperative body temperature on 1 st day and mechanical ventilation. Conclusion Stroke patients undergoing surgical treatment are high-risk group of healthcare-associated infection,effective prevention and control measures targeting risk factors should be taken to reduce healthcare-associated infection rate in the population.
Objective To investigate the current status of healthcare-associated infection among stroke patients undergoing surgical treatment,and to explore the risk factors of healthcare-associated infection. Methods Eligible patients hospitalized in the neurosurgery department in a tertiary comprehensive teaching hospital from January 1 st,2016 to December31 st,2017 were recruited. Necessary information of patients was collected and filled in the self-designed forms: Target surveillance investigation forms of healthcare-associated infection among stroke patients undergoing surgical treatment. Results Overall,466 eligible patients were enrolled in this study,133 healthcare-associated infection cases( 154 episodes),and the incidence of healthcare-associated infection was 28. 54%. Healthcare-associated infection risk factors for stroke patients undergoing surgical treatment were identified with the hemorrhagic stroke,Glasgow Coma Scale( GCS) at admission,length of stay( LOS),venous thrombosis,postoperative body temperature on 1 st day and mechanical ventilation. Conclusion Stroke patients undergoing surgical treatment are high-risk group of healthcare-associated infection,effective prevention and control measures targeting risk factors should be taken to reduce healthcare-associated infection rate in the population.
引文
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[11]沈波,喻荣彬,许琴芬,等.无锡市某三级医院重症监护病房医院感染危险因素研究[J].华西医学,2016,31(9):1568-1571.
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[2] Sun H,Zou X,Liu L. Epidemiological Factors of Stroke:A Survey of the Current Status in China[J]. Stroke,2013,15(2):109-114.
[3] Westendorp WF,Nederkoorn PJ,Vermeij JD,et al. Post-stroke infection:a systematic review and meta-analysis[J]. BMC Neurol,2011,11:110.
[4]陈素平,黄琴香.脑卒中患者医院感染相关因素分析[J].中华医院感染学杂志,2010,20(17):2584-2585.
[5]刘光健,陈俊,王云甫,等.中国人出血性与缺血性脑卒中患者医院感染易感性荟萃分析[J].中国神经精神疾病杂志,2010,36(11):684-687.
[6] Green SM. Cheerio,laddie! Bidding farewell to the Glasgow Coma Scale[J]. Ann Emerg Med,2011,58(5):427-430.
[7] Ncül O,Ksüz S,Acar A,et al. Nosocomial infection characteristics in a burn intensive care unit:analysis of an eleven year active surveillance[J]. Burns,2014,40(5):835-841.
[8]阎田园,梁海峰,王书会,等.某医院ICU住院患者耐药菌感染危险因素分析[J].中国消毒学杂志,2018,35(2):114-117.
[9]杨士勇,刘现金,张启恩.中医论治骨科术后非感染性发热[J].中医临床研究,2014,23(6):85-86.
[10]张诗海,周章武.中医辨证治疗骨科术后非感染性发热的临床进展[J].中医药临床杂志,2015,27(9):1328-1330.
[11]沈波,喻荣彬,许琴芬,等.无锡市某三级医院重症监护病房医院感染危险因素研究[J].华西医学,2016,31(9):1568-1571.
[12]赵丹.呼吸机相关性肺炎的护理集束化干预[J].科技资讯,2013,(20):226-227.